Britain's NHS - One of the the worst health services in Western Europe - How it can be fixed
Politics / NHS Mar 12, 2007 - 12:04 AM GMTBy: Nadeem_Walayat
A tripling in annual NHS budget to £110 billions, and Britain is still inflicted with the worst health care in Western Europe. Even the BMA admits that 2006 was a bad year for the NHS, and with budgets increasingly being allocated from patient heath care to pay NHS employee pay rises, 2007 looks set to be an even worse year.
Why ?
Because those that decide on where the money is spent, are those that benefit from that money going straight into their own pockets. That's GP,s Hospital Doctors, Consultants and other Managerial NHS Staff.
Those that should be benefiting from a tripling in expenditure, i.e. the Patients have very little say on whether a GP service or Hospital is rubbish, and should be closed down. No, its the staff of that institution which decide that they should continue in practice, maybe they feel they deserve 30% pay rises per annum ? I.e. as GP's have enjoyed in recent years.
Though, I'm sure that 99% of patients would strongly disagree and perhaps even suggest that the GP and NHS services have deteriorated in recent years. As to save costs foreign doctors and staff have been brought in who can barely utter two words of English, dumped into the casualty words and after hour GP service areas. Who basically do not have a clue what they are doing !
Whether it by the GP surgery, casualty or the multitude of NHS departments such as the eye clinics. Invariable the first port of call is a foreign doctor or 'practician' with poor language skills accompanies dubious qualifications that has the power to send patients away with real symptoms. Who only later, after the condition has deteriorated are referred back to the said department to do the job properly ! Or in other circumstances the patient has gone off to PAY for private healthcare that is the whole purpose of the NHS's existence to service.
Even injured soldiers returning from the Iraq war, dumped in the NHS are complaining that they should be treated in Military Hospitals because the quality of healthcare is so bad. Better treatment than the rest of us ? There used to be 11 Military hospitals, now there is just 1.
Things are bad and expected to get much worse, despite the extra billions thrown at the NHS year in year out which just results in ever more cuts ! The next big cloud hanging over the NHS is the £61 billion pensions black hole that continues to grow ! This will mean more resources will be diverted from healthcare to fund the lush pension schemes that the vast majority of British public can only dream about.
What can be done about it ?
1. Avoid sentimentality - Don't get automatically sucked into the gravy train brigades persistent resistance to any type of market orientated reforms that attempt to introduce accountability and some resemblance of patient say in the matter. After all as anyone knows, money talks, but NOT currently where the NHS is free at the point of delivery !
2. Research the Facts - Do some research into the actual state of the NHS. Look at the facts rather than the propaganda. The facts speak for themselves. I.e. GP's rewarding themselves 30% annual pay rises. Hospitals running with outdated procedures, because the Consultants don't want to update into the 21st Century. An NHS where nurses and staff cannot even perform rudimentary hygiene, hence the outbreaks of 'super bugs' killing over 5000 a year.
3. Evaluate the alternatives to the current NHS system- The system is NOT working. And something drastic needs to be done. £110+ billions a year is more than enough to provide a decent health-care system We are paying for it, but not receiving it. Hence the people to decide whether a hospital is good or rubbish or a GP surgery is good or rubbish is the PATIENT, NOT those on the gravy train ! Not the Doctors, NOt the Management, Not the Consultants. But the Patients ! And it they decide the service is more or less worthless than THAT hospital or GP Surgery should be closed !
4. Reduce Reliance on Foreign Workers - As with the experiences of people in the Britain, by the switch to Foreign Call Centre's, the quality of service experienced has dropped. We should be training more of our young unemployed to be employed in the NHS rather than shifting in foreign workers from all over the world with relatively poor language skills, lack of understanding of the culture and patients and what the NHS is. Who invariable come from a culture where healthcare is paid for at the point of delivery. Hence when dropped into a free NHS system, invariably adopt the arrogance associated with treating someone for Free! Well its NOT Free, British tax payers, pay through the nose for this health care service.
5. Work for the NHS or the Private Sector - Not Both -The Doctors and Consultants need to be reigned in, they either work solely for the NHS, or they work solely for the private sector, this business of GP's collecting £100k+ on the NHS AND working for the private sector is totally unacceptable ! If someone on benefits also worked, then they would be in the courts for benefit fraud. This is one of the problems why we have to drag in foreign doctors to cover for NHS doctors off on a private session.
6. Part-Payment System - Both the patients, doctors and other medical practioners need to be able to see the monetary value of the service they are providing. This may mean a full privitisation of the NHS, or it may mean some sort of pre-payment, part-payment or voucher system. Where the money goes with the patient. So rather then view the patient as an inconvenience to get rid of quickly through the door, so as the next person can come in to up the numbers. The actual service from THAT patient directly carries a real value that the patient has a say with where it should go. I.e. choice of service. As with private medicine. The Hospital or Doctor you have booked a session with understands that they need to always do a good job ! Else they will lose business. This does NOT happen in the NHS, rather the poorer the service the more money in the pocket as less costs are incurred in treatment of patients.
A part-payment system is employed successfully in much of Europe, including socialist France where patients pay 1 euros towards a consultation. Even a small sum being handed over by the patient to the GP carries with it some exchange of value. If such a system were implemented in the UK where say each patient paid £10 per consultation then the quality of service afforded to patients would improve greatly !
A part-payment system would also make patients resistance to visiting their GP's with trivial conditions such as colds and flu.
7. GP Contracts mess needs to be fixed - The call went out that Doctors should have greater say in surgery budgets. Well we saw what the consequences of this was, GP's awarding themselves 30% pay deals per annum. Human nature being what it is, greed has meant billions are being wasted. Therefore there needs to be an urgent review of poorly thought out contracts and salaries and Lush pension schemes need to be reigned in so that there is some sort of incentive to perform effective the day to day duties of patient diagnosis rather then day dream of how to spend the extra thousands given as a result of Government incompetence and the greed of GP's.
8. Effective Management of Hospitals - Take power away from consultants and doctors and place it with people who know how to manage a large organisation, brought in from the private sector. Literally thousands of patients are needlessly dieing due to hospitals using outdated techniques and procedures, because consultants and other medical staff are resistance to change. This was recently highlighted in a BBC2 documentary following Management Guru Gerry Robinson's attempts at diagnosing the NHS's terminal condition.
In the final analysis, we have to decide, do we want an national heath service that is primarily for those that work for it, or for the patients for whom it is meant to serve.
By Nadeem Walayat
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